Abstracts

Rationale: Epileptologists have recognized the importance of identifying comorbid mood and anxiety disorders in patients with epilepsy. However, screening for suicidal ideation and /or behavior is rarely performed, despite their higher suicidal risk. Furthermore, there are little data on the prevalence of current and /or past suicidal ideation and /or behavior at the time of the diagnosis of epilepsy. The aim of this study was to address this question in subjects with newly diagnosed focal epilepsy and to establish the prevalence of suicidality specifically in those patients with comorbid mood and / or anxiety disorders. Methods: Data for this study was obtained from the Human Epilepsy Project. The MINI International Neuropsychiatric Interview was used to identify a DSM-IV-TR diagnosis of current and /or past mood (Major Depression, Dysthymia, manic and hypomanic episodes) and anxiety disorders (Generalized anxiety disorder, panic disorder, social phobias). MINI data were available in 379 adult subjects. Current and lifetime suicidal and ideation (passive and active) and attempts were obtained with Columbia Suicidality Severity Rating Scale (CSSRS); data were available in 450 adult subjects. Results: Among the 450 subjects with newly diagnosed focal epilepsy, lifetime suicidal ideation was identified in 105 (23%); among these subjects, active suicidal ideation was present in 67 (14.5%). Current suicidal ideation (defined as present in the previous 6 months) was endorsed by 44 subjects (9.8%), 23 of whom (5%) experienced active suicidal thoughts. Previous suicidal attempts were endorsed by 24 subjects (5.3%). Among the 379 subjects with available MINI data, a past and /or current history of mood and /or anxiety disorders was found in 148 (38.8%); 65 (44%) of these subjects endorsed suicidal ideation and /or behavior, Active suicidal ideation was identified in 45 (30.5%), while 16 (11%) subjects had a prior suicide attempt. Positive suicidal ideation was identified in 19 (8%) of 230 subjects without mood and /or anxiety disorders and a suicide attempt was only reported by one (0.4%) subject. Conclusions: Comorbid suicidality is relatively frequent in patients with newly diagnosed focal epilepsy, in particular among those with a mood and / or anxiety disorder. Accordingly, screening for suicidality is as important as investigation of mood and /or anxiety disorders in the early stages of any evaluation of patients with focal epilepsy.    Funding: The HEP study is supported by the Epilepsy Study Consortium (ESCI), a non-profit organization dedicated to accelerating the development of new therapies in epilepsy to improve patient care. The funding provided to ESCI to support HEP comes from industry, philanthropy and foundations (UCB Pharma, Eisai, Pfizer, Lundbeck, Sunovion, The Andrews Foundation, the Vogelstein Foundation, Finding a Cure for Epilepsy and Seizures [FACES], Friends of FACES and others).